How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2.04 Median $2.69 Typical High $3.55 | Facility | None | $2.04 | $2.69 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.14 | Professional | None | $2.04 | $2.04 | $2.14 |
Ambetter Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.24 Median $3.09 Typical High $4.47 | Facility | None | $2.24 | $3.09 | $4.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.04 Median $3.80 Typical High $3.89 | Professional | None | $2.04 | $3.80 | $3.89 |
CareSource Setting Facility Modifier None Typical Low $2.00 Median $2.00 Typical High $3.55 | Facility | None | $2.00 | $2.00 | $3.55 |
CareSource Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.19 | Professional | None | $2.00 | $2.00 | $2.19 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $2.09 Typical High $4.17 | Professional | None | $1.58 | $2.09 | $4.17 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $3.47 Median $4.47 Typical High $6.17 | Facility | None | $3.47 | $4.47 | $6.17 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2.24 Median $4.07 Typical High $5.50 | Professional | None | $2.24 | $4.07 | $5.50 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.09 Typical High $2.75 | Professional | None | $2.04 | $2.09 | $2.75 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.00 Median $1.02 Typical High $1.02 | Professional | 52 · Reduced service | $1.00 | $1.02 | $1.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.41 Typical High $0.41 | Professional | 53 · Discontinued | $0.40 | $0.41 | $0.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.31 Typical High $0.31 | Professional | 55 · Aftercare only | $0.30 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.20 |
Where Indiana sits
The same service costs 2.1 times more in Wyoming than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 2nd of 51
$3.80
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.